The department has already fined the hospital $80,000, which is the highest amount allowed. A state Health Department spokeswoman said state surveyors found a host of problems.

"We've looked very closely at the situation and the past reports we've had, and we determined that the fine was what we needed to assess in this situation," a department representative said.

The problems included three patients, a 3-year-old, a 4-year-old, and a 17-year-old, who went to the hospital saying they were sexually abused.

The state found no documentation that physicians used a rape kit on the patients, provided the services of a sexual assault nurse or reported the alleged abuse to police.

"Without the documentation, we have to assume that those reports did not take place because it's required by law that they document that they took care of all of these patients," said Health Department spokeswoman Christine Cronkright.

Hospital CEO John Kristel admits hospital employees made some mistakes.

Kristel said that the errors were due to a failure to document, not mistakes that put children in danger.

"Carlisle Regional Medical Center has developed a plan of correction, which has been accepted by the state Department of Health. We accept full responsibility for documentation errors cited by the department and are implementing a plan to assure they do not recur. However, we respectfully disagree that we failed to report three cases of possible child sexual abuse to the proper authorities," hospital officials said in a statement.

"Our plan of correction properly addresses issues of documentation, and we have educated our staff on these expectations. We are confident it will assist us in providing the best possible care for our patients," hospital officials said in a statement.

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